Trajectories of resilience over 25 years of individuals who as adolescents consulted for substance misuse and a matched comparison group

Addiction. 2010 Jul;105(7):1216-25. doi: 10.1111/j.1360-0443.2010.02914.x. Epub 2010 Mar 10.


Aims: To examine trajectories of resilience over 25 years among individuals who as adolescents received treatment for substance misuse, the clinical sample (CS) and a matched general population sample (GP).

Design: Comparison of the CS and GP over 25 years using Swedish national registers of health care and criminality.

Setting: A substance misuse clinic for adolescents in an urban area in Sweden.

Measurements: Resilience was defined as the absence of substance misuse, hospitalizations for physical illnesses related to substance misuse, hospitalization for mental illness and law-abiding behaviour from ages 21 to 45 years.

Participants: The CS included 701 individuals who as adolescents had consulted a clinic for substance misuse. The GP included 731 individuals selected randomly from the Swedish population and matched for age, sex and birthplace.

Findings: A total of 52.4% of the GP and 24.4% of the CS achieved resilience in all domains through 25 years. Among the CS, another one-third initially displayed moderate levels of resilience that rose to high levels over time, one-quarter displayed decreasing levels of resilience over time, while 9.3% showed little but improving resilience and 8.8% showed no resilience. Levels of resilience were associated with the severity of substance misuse and delinquency in adolescence.

Conclusions: Individuals who had presented substance misuse problems in adolescence were less likely to achieve resilience over the subsequent 25 years than was a matched general population sample, and among them, four distinct trajectories of resilience were identified. The severity and type of problems presented in adolescence distinguished the four trajectories.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Adolescent Health Services
  • Adult
  • Age Factors
  • Anxiety / epidemiology
  • Child
  • Crime / statistics & numerical data
  • Depression / epidemiology
  • Epidemiologic Methods
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Recurrence
  • Resilience, Psychological*
  • Severity of Illness Index
  • Socioeconomic Factors
  • Substance Abuse Treatment Centers*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation*
  • Sweden / epidemiology
  • Urban Population
  • Young Adult